MR-proAdrenomedullin as a predictor of renal replacement therapy in a cohort of critically ill patients with COVID-19.
Biomarkers
; 26(5): 417-424, 2021 Jul.
Article
in English
| MEDLINE | ID: covidwho-1146879
ABSTRACT
BACKGROUND:
About 20% of ICU patients with COVID-19 require renal replacement therapy (RRT). Mid-regional pro-adrenomedullin (MR-proADM) might be used for risk assessment. This study investigates MR-proADM for RRT prediction in ICU patients with COVID-19.METHODS:
We analysed data of consecutive patients with COVID-19, requiring ICU admission at a university hospital in Germany between March and September 2020. Clinical characteristics, details on AKI, and RRT were assessed. MR-proADM was measured on admission.RESULTS:
64 patients were included (49 (77%) males). Median age was 62.5y (54-73). 47 (73%) patients were ventilated and 50 (78%) needed vasopressors. 25 (39%) patients had severe ARDS, and 10 patients needed veno-venous extracorporeal membrane oxygenation. 29 (45%) patients required RRT; median time from admission to RRT start was 2 (1-9) days. MR-proADM on admission was higher in the RRT group (2.491 vs. 1.23 nmol/l; p = 0.002) and showed the highest correlation with renalSOFA. ROC curve analysis showed that MR-proADM predicts RRT with an AUC of 0.69 (95% CI 0.543-0.828; p = 0.019). In multivariable logistic regression MR-proADM was an independent predictor (OR 3.813, 95% CI 1.110-13.102, p<0.05) for RRT requirement.CONCLUSION:
AKI requiring RRT is frequent in ICU patients with COVID-19. MR-proADM on admission was able to predict RRT requirement, which may be of interest for risk stratification and management.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Protein Precursors
/
Critical Illness
/
Renal Replacement Therapy
/
Adrenomedullin
/
Acute Kidney Injury
/
SARS-CoV-2
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
English
Journal:
Biomarkers
Journal subject:
Biochemistry
Year:
2021
Document Type:
Article
Affiliation country:
1354750X.2021.1905067
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